Christopher Chope: But surely if the hybridity issue will not arise, there is no need for Lords amendment No. 1. If the hybridity issue may issue, that will only be because private interests may be being prejudiced as a result of a transfer. If private interests are going to be prejudiced as a result of a transfer, surely it is right that the hybrid instrument procedure in the other House should be applicable.

Lembit �pik: I congratulate the hon. Member for Bournemouth, West (Sir John Butterfill) on his prodigious production of legislation. Given that this is his fourth Bill of the session, I suggest that he is rather more successful at running the country than most Ministers. I also congratulate the hon. Member for Fareham (Mr. Hoban) on identifying so many causes of fear in just six amendments. I do not mean to be rude, but I feel that rather than this being a celebration of detail, there is a hint of paranoia over the possibility that the hon. Member for Bournemouth, West may be trying to slip one under the wire and cause the permanent descent of financial mutuals in the United Kingdom into the hands of the operators of vineyards in France.
	The hon. Member for Fareham made an interesting point about hybridity. I should like to know the Minister's views on that, but it seems to me that Lords amendment No. 1 reduces the risk of application of the instruments relating to hybridity. I can see why that is attractive to the industry: it streamlines the process and, as far as I can see, reduces the opportunity for public debate about such changes. Conversely, if the amendment does indeed work in the private interests of companies, it may not necessarily work in the interests of investors or the public in general. Perhaps the Minister could give us her perspective on whether there will be unreasonable restriction of the opportunity for public participation if the hybrid-instrument procedure is used less often.

Christopher Chope: It is indeed narrow, Madam Deputy Speaker, but may I submit that it is also very important, because it is on a subject that affects the rights of the individual subjects of our country?
	As my hon. Friend the Member for Bournemouth, West has pointed out, there is a problem regarding the time that the procedure can take. However, as I did earlier, I draw his attention to House of Lords Standing Order No. 216A.
	It provides for the expedited procedure, under which the Bill does not have to be considered in such detail, and states that the
	hybrid instrument...which, by virtue of the Act authorising it to be made, is, after the expiry of a period prescribed by that Act...to proceed in Parliament as if its provisions would, apart from that Act, require to be enacted by a public bill that is not hybrid...referred to as an expedited hybrid instrument.
	The procedure for such an instrument differs from that applicable to other hybrid instruments.
	The standing order continues:
	A petition...not to affirm an expedited hybrid instrument shall be...deposited...within ten days beginning with the day on which the instrument is laid.
	If the Hybrid Instruments Committee is of the opinion that there ought to be a further inquiry, it conducts that inquiry itself, forthwith. After 10 days, if there is some substance to the petition, the matter is inquired into; the Hybrid Instruments Committee does that itself. The procedure could not be used, as has been suggested, by potential rival bidders, although we know from what happens in the real world that such bidders often get up to all sorts of tricks. We have seen that in relation to a recent takeover of a bank, although we shall leave that to one side.
	I took the liberty of asking the House of Commons Library about the implications of Lords amendment No. 1. Its reply states:
	In general terms those who would have wished to petition against a hybrid instrument would be adversely affected, as treating such an instrument as an ordinary instrument precludes the right to petition.
	It continues:
	Exactly who those individuals or groups would be would depend on the provisions in the instrument.
	That almost goes without saying. This real issue could act adversely against members of mutual societies when they find that their directors have it in mind to sell their interests to other organisations in the European economic area. Those agreed members should have the chance to take advantage of the procedure that I have outlined.
	The problem that I have about all this is that if we reject Lords amendment No. 1, it might jeopardise the whole Billit would depend on whether their lordships could be reconvened to accept our disagreement with it. I hope that the Minister will express her good intentions and those of the Government in respect of how those individuals who might be adversely affected will be protected if that cannot be done by the hybrid instrument procedure.
	I am worried about the predatory action that may come from some EEA mutual insurers. Mutual insurers are basically are known much more on the continent than in our country. I shall now translate a document from French. The international association of mutual assurance societies is based in Brussels, in what is sometimes described as the heart of Europe. It produced a helpful note on what mutual insurance is and why one must use it. Under the heading opportunities, it identifies the fact that the insurance market is still expanding because the universe of risks is doing so too. That universe is indeed expanding, but those are risks not only that people want to have insured, but they are risks for insurance companies. The larger the risks insured, the larger the risk to those companies. We know what happened to Lloyd's members.
	What happens when people invest in a mutual savings society and find that that society's interests are taken over by a mutual insurance company which then, in order to buy insurance business, insures things that it should not have done and ends up going bust? Where does that leave the savers in the mutual society originally based in the UK, who may have lost everything? Surely we should safeguard against such a situation. We should be alert to the prospect of predatory action.
	Before I turn to the other amendments, may I tell hon. Members that the issue of hybrid instruments was examined by the Joint Select Committee on Delegated Legislation in 1972-73? Those recommendations were accepted by both Houses. The Committee was chaired by the late Lord Brooke of Cumnor, the father of the current Lord Brooke of Sutton Mandeville, whom I had the privilege of serving for a short time as a Parliamentary Private Secretary when he was a Treasury Minister. That is a distinguished family of statesmen.

Philip Davies: My hon. Friend has been in Parliament much longer than I have and knows all the tricks of the trade that Governments can use. Something that sounds reassuring at a superficial level may not be so in reality. I am grateful to him for reminding me of the dangers that he has outlined.
	I would like the Minister to address another aspect of amendment No. 3. When we discussed that before, the then Economic Secretary to the Treasury, now Secretary of State for Children, Schools and Families, said that the mutual insurers had to be left out of the Bill because of the possibility of contravening EU law. He said:
	We have considered whether the Bill could be extended to cover companies limited by guarantee that are also insurers, but because insurance is regulated on a Europe-wide basis, we would have to allow the same procedures to apply where the transfer is to a subsidiary of the body corporate in another member state which is similar to a company limited by a guarantee...For that reason, and despite our efforts, we were not able to include mutual insurers in[ Official Report, 27 April 2007; Vol. 459, c. 1156.]
	the new clause in Committee. Given that that was turned on its head when Lord Evans said that the amendment
	is wide enough to encompass mutual insurers and, by permitting transfers under the new provisions to a mutual society established in any EEA state, it ensures that there will be no breach of EC law[ Official Report, House of Lords, 10 July 2007; Vol. 693, c. 1356.],
	it would be helpful for the Minister to explain how we have gone from the stage of something being specifically ruled out, because it would breach EU law, to the stage that we are at now, where something is going to be incorporated to ensure that it complies with EU law. That strikes me as a sharp turnaround in a short space of time. What assurances can she give that the legal opinion on which the amendment is based will not be subject to challenge and will be watertight for the future? I am not a lawyer, and my hon. Friend the Member for Christchurch knows much more about such things that I do, but if we can have a turnaround in a legal opinion in such a short time, I am not convinced that there cannot be a further turnaround in future.
	We have not discussed amendments Nos. 4 and 5 very much, but it seems that they are necessary to comply with EU law. Perhaps the Minister can clarify that. Without them, a mutual in another EEA state would have to establish a UK company subsidiary to benefit from the changes, which might place it at a disadvantage. The changes would ensure that UK and EEA mutual societies were treated equally. The amendments' purpose is not to benefit UK mutual societies in particular, but to benefit mutual societies in other EEA member states.

Kitty Ussher: That is not my understanding. The amendments address the specific point that my predecessor made in Committee: if you want to extend the Bill to mutual insurers, there is a corresponding issue of ensuring that the provision is not challenged under EU law, which I think is right and proper. I am simply telling the hon. Gentleman of what I have been technically advised.

Christopher Chope: Madam Deputy Speaker, my right hon. Friend particularly asked me to say that because the mother of the hon. Member for Hendon lives in his constituency in Bridlington, he thought that he was serving the family

Christopher Chope: All that I can say to my hon. Friend is that when I had the privilege of being a Minister, albeit a junior one, in a Conservative Government, we always took seriously the rulings and recommendations of appeal bodies. Being a fair-minded person, I would like to think that the present Government, for all their faultsI am delighted to see the Parliamentary Secretary to the Cabinet Office, hon. Member for Lincoln (Gillian Merron), on the Front Benchwould be minded to accept the recommendations of a tribunal. My hon. Friend tempts me to make a party political point, but I will not do so on this occasion.

Christopher Chope: I am bound, in a sense, by the text of my own new clause and as it is drafted, the tribunal could make only a recommendation, whichgiven the meaning of the word recommendationthe Government could accept or reject. However, if we set up the tribunal properly, with the right people who command respect from all sides of the debate, and if they are properly advised, take proper evidence and go into the necessary detail of individual cases, I would hope that any recommendation would be so compelling that it would be almost impossible for a Government reasonably to reject it.

Derek Conway: I am sorry that we are pressing my hon. Friend on this issueI hope that he is not offended by that. I am not quite sure who the better class of person is to whom he referred. Perhaps my hon. Friend the Member for West Chelmsford is the better class of person whom he wants. May I press my hon. Friend the Member for Christchurch (Mr. Chope) on the point that my hon. Friend the Member for West Chelmsford raised? If a Minister declines to accept the tribunal's recommendation, what happens then? Would the members of the tribunal resign? Would there be another form of appeal? My hon. Friend will understand why the House would like to hear the detail on the consequences of Ministers' actions. As we know, Ministers do not always decide as we would like them to.

Philip Davies: Given my hon. Friend's answer to a previous intervention about the fact that if a tribunal had considered all the evidence in a robust and thorough manner and everybody could see that it was all above board, a Minister would be unlikely to reject the recommendations, does he intend that the tribunal would take evidence in public and that its findings would be made public so that people could hold the Minister to account should it overrule the decision?

Philip Davies: My hon. Friend is absolutely right and as the hon. Member for Hendon made clear, if the Bill does go through during this Session, he will bring it back at some future stage. Perhaps the House is doing him a service today by making sure that when he does bring it back, if he takes into account all the points that have been made, there will be no need for it to be so delayed. I suspect that, contrary to the point made by the hon. Member for Montgomeryshire (Lembit pik)that this debate is causing the Bill problemsit is helping it in the long run.

Christopher Chope: I, too, have constituents who are concerned about Equitable Life, but unless I have missed something my understanding is that the case is still being considered by the parliamentary ombudsmaneven at this late stage. She has yet

Ann Keen: I congratulate the hon. Member for Old Bexley and Sidcup (Derek Conway) on securing this debate on the future of Queen Mary's hospital, Sidcup. I also thank those of my hon. Friends and other hon. Members who have participated so well in the debate and shown passion for and concern about their local NHSa passion and concern that we all share nationally regarding the changes that we are to make in the health service. I know that this issue is of concern to the hon. Gentleman and his constituents, and I appreciate the comments that he and others have made in the House today.
	I also congratulate Queen Mary's Sidcup on how it has turned itself aroundI acknowledge the remarks and tributes of the hon. Member for Old Bexley and Sidcup at the beginning of this debateand staff in south-east London on the hard work that they have put into improving services and performance. Millions of people are receiving high quality and safe services every day. The best of the national health service is among the best health care in the world. We should all be proud of its achievements and, given the comments made in this House today, I know that all hon. Members are.
	For that reason, I understand that when we talk about potential changes in services, it leads to huge public interest, debate, and, in some cases, anxiety. I recognise that change is difficult and appreciate that it can provoke powerful reactions from stakeholders. When people talk about the reorganisation of services, they think that it is about saving money; it is not. It is about saving more people's lives and making care more convenient for local people.
	Lifestyles, society, medicine, technology and the NHS itself have all changed over the past 60 years. Medicine is, and always should be, dynamic. Change is nothing new in the NHS. It has always responded to change and the latest treatments by organising itself to deliver that care. We are responding to a variety of drivers for change now.
	The aim of the A Picture of Health project is to improve the quality, safety and patient experience of local services. That can be achieved only through changes in how those services are delivered. The proposed benefits to patients will be services available closer to their home and specialist hospital services concentrated closer together. That is the aim of all reviews and of this one in particular. That approach will improve patients' experience by providing safer services and ensuring that all specialists have the appropriate experience and expertise.
	The A Picture of Health project is clinically led. Clinical staff across the four outer south-east London boroughs and in the four hospital trusts take a lead in determining how services should best be delivered in the future in those four trusts. More than 100 hospital-based staff took part in a plenary session held on 25 September and further consultation with clinical staff working in the community is also taking place. In addition, there has been strong stakeholder engagement throughout late 2006 and 2007, beginning with The Big Ask website consultation run by Ipsos Mori from October 2006 to January 2007 and continuing with four public engagement events.
	The national clinical advisory team, under Professor Sir George Alberti's leadership, is reviewing the emerging options for change during October 2007, giving further assurance that the clinical case for change can be delivered. Further to the events organised during September and October to gather opinions from clinical staff, Sir George Alberti is talking to a wide range of local stakeholders during October and there will be two public feedback events ahead of full public consultation. Examining the health service involves such a dramatic change, and this is a good way of consulting. I know that all hon. Members will take part in those consultations with their constituents.
	As part of the consultation, I also understand that Sir George Alberti visited Queen Mary's Sidcup yesterday morning and discussed the case for change and the emerging proposals with a range of doctors and other health professionals. Perhaps hon. Members would like to look into what happened following those discussions. I believe that there will be an opportunity for the hon. Gentleman to discuss any concerns that he has with Sir George before he concludes his review. I reassure him that consultation on proposals for service change will not begin before Sir George has reported on his review.
	I appreciate the great interest that the hon. Gentleman has taken in the review at a local level, and the way in which hon. Members have spoken in this debate. I understand the specific issue that the hon. Member for Old Bexley and Sidcup has raised today in relation to the A Picture of Health programme.
	On 30 August, Lord Warner, the chair of the NHS London provider agency, agreed with the chairs and chief executives of the four hospital trusts that a proposal for a single executive team across all four trusts should be looked into. Each of the four trusts is currently assessing, individually and collectively, the merits of establishing a single executive team to support their own separate trust boards, which would be retained. A final decision has yet to be taken, but I understand that this proposal could help to facilitate the significant change programme across the local health economies and enable the development of services that will provide best value for money in the future.
	The four south-east London trusts are on the Department's list of financially challenged trusts. The NHS London provider agency continues to work with each trust to develop a range of options for solving the indebtedness while maintaining standards of patient care and value for money. Our Department is working closely with strategic health authorities to identify long-term solutions for the trusts. I must reiterate that this work is not the driving force for the review of servicesthat is the clinical case for change.